1. Temporal trends in disease presentation and survival of patients with hepatocellular carcinoma: A real-world experience from 1998 to 2015.
- Author
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Kim NG, Nguyen PP, Dang H, Kumari R, Garcia G, Esquivel CO, and Nguyen MH
- Subjects
- Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic statistics & numerical data, Chemoembolization, Therapeutic trends, Female, Hepatectomy statistics & numerical data, Hepatectomy trends, Hepatitis B pathology, Hepatitis B virology, Hepatitis C pathology, Hepatitis C virology, Humans, Incidence, Kaplan-Meier Estimate, Liver pathology, Liver virology, Liver Neoplasms diagnosis, Liver Neoplasms pathology, Liver Neoplasms therapy, Liver Transplantation statistics & numerical data, Liver Transplantation trends, Male, Mass Screening statistics & numerical data, Middle Aged, Non-alcoholic Fatty Liver Disease pathology, Palliative Care statistics & numerical data, Palliative Care trends, Retrospective Studies, Time Factors, United States epidemiology, Carcinoma, Hepatocellular mortality, Hepatitis B epidemiology, Hepatitis C epidemiology, Liver Neoplasms mortality, Mortality trends, Non-alcoholic Fatty Liver Disease epidemiology
- Abstract
Background: Hepatocellular carcinoma (HCC) is one of the few cancers whose incidence continues to increase. The goal of the current study was to investigate the presentation and survival trends of patients with HCC presenting to a university hospital between 1998 and 2015., Methods: Study data were ascertained by individual chart review with survival data also supplemented by National Death Index query up to December 31, 2015. Patients were divided into three 6-year groups by diagnosis date (1998-2003, 2004-2009, and 2010-2015)., Results: A total of 2106 consecutive patients with HCC were included. The majority of patients had either hepatitis C (56.7%) or hepatitis B (22.1%), but cases of nonalcoholic steatohepatitis HCC increased by 68% over the most recent time period. Screening/surveillance identified 61% of HCC cases, but only 31% of these patients underwent curative treatment, which did not increase significantly over time. The overall median survival was 29.8 months (2.48 years) and without improvement over time. On multivariable analysis, Asian or Hispanic ethnicity, meeting Milan criteria, and receiving any of the standard HCC treatments were found to be significantly associated with improved survival, but diagnosis time period and liver disease etiology were not., Conclusions: Over the last 18 years, the percentage of cases of nonalcoholic steatohepatitis HCC has increased but not overall survival. It is interesting to note that only 31% of patients with HCC identified via screening/surveillance received any curative treatment. Further research is needed to better understand the barriers to curative care for patients with HCC and the causes of the lack of improvement in survival in the more recent patient cohort. Cancer 2018;124:2588-98. © 2018 American Cancer Society., (© 2018 American Cancer Society.)
- Published
- 2018
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